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Biomedical subjects

E Eerola

Publications and source records attributed to E Eerola.

At least 37 records · Page 2Linked to original sources
PubMed1997

Faecal microbial flora and disease activity in rheumatoid arthritis during a vegan diet.

To clarify the role of the faecal flora in the diet-induced decrease of rheumatoid arthritis (RA) activity, 43 RA patients were randomized into two groups: the test group to receive living food, a form of uncooked vegan diet rich in lactobacilli, and the control group to continue their ordinary omnivorous diets. Based on clinical assessments before, during and after the intervention period, a disease improvement index was constructed for each patient. According to the index, patients were assigned either to a group with a high improvement index (HI) or to a group with a low improvement index (LO). Stool samples collected from each patient before the intervention and at 1 month were analysed by direct stool sample gas-liquid chromatography of bacterial cellular fatty acids. This method has proved to be a simple and sensitive way to detect changes and differences in the faecal microbial flora between individual stool samples or groups of them. A significant, diet-induced change in the faecal flora (P = 0.001) was observed in the test group, but not in the control group. Further, in the test group, a significant (P = 0.001) difference was detected between the HI and LO categories at 1 month, but not in the pre-test samples. We conclude that a vegan diet changes the faecal microbial flora in RA patients, and changes in the faecal flora are associated with improvement in RA activity.

Arthritis, Rheumatoid↗
PubMed1996

Eradication of the long-term carriage of methicillin-resistant Staphylococcus aureus in patients wearing dentures: a follow-up of 10 patients.

To cure the long-term carriage of methicillin-resistant Staphylococcus aureus (MRSA), eradication treatment was given to 10 patients wearing complete dentures. In addition to multiple body sites, MRSA was cultured from the dentures of six patients. The contaminated dentures were rebased and sterilized with heat in order to prevent recolonization. The patients did not use their dentures during the decolonization therapy. Subsequently, MRSA was eradicated from three of these patients but three others remained MRSA-positive despite at least two courses of combined systemic and topical eradication treatment. These particular patients had persistent stomatitis and their dentures were a poor fit, in poor condition and repeatedly grew MRSA. Eradication treatment was successful in the remaining four patients whose dentures were MRSA-negative. These results confirm that dentures may function as foreign bodies and sustain persistent nasopharyngeal. MRSA colonization. Therefore, we suggest that whenever eradication of MRSA is deemed necessary in cases of nasal, oral or pharyngeal carriage, heat treatment of the dentures should be included. Further comparative studies with larger patient populations are needed to evaluate the contribution of dentures to the long-term carriage of MRSA, as well as to assess the value of denture sterilization during the eradication course.

Aged↗
PubMed1996

Genetic diversity among Mycobacterium avium complex AccuProbe-positive isolates.

The partial 32-kDa-protein gene sequences of 22 Mycobacterium avium complex (MAC) clinical isolates that were positive by the AccuProbe MAC probe only (not by the M. avium or M. intracellulare probe) were determined. The obtained nucleotide sequences were compared with the published sequences for M. tuberculosis, M. avium, and M. intracellulare by a sequence analysis program. There was a wide range of genetic diversity among the strains studied. Most of them (16 of 22) had sequences similar but not identical to those of M. avium and M. intracellulare. These strains were considered to be true MAC strains. Five strains had sequences in the category of the novel MAIX sequence, which was very different from the sequences of other mycobacteria analyzed thus far. In addition to these strains, one isolate had a sequence that differed greatly from the reference sequences. These results support previous findings showing that the MAC probably contains several additional species. Our results also suggest that the MAC AccuProbe may react with strains that do not belong to the MAC.

Bacterial Proteins↗
PubMed1996

Diagnosis of disseminated candidiasis by measurement of urine D-arabinitol/L-arabinitol ratio.

Relative amounts of D-arabinitol (fungal origin) and L-arabinitol (part of normal human metabolism) in urine were determined by gas chromatography and mass spectrometry from 61 hospitalized patients with hematological malignancies. Seventeen neutropenic patients with acute leukemia (with 53 samples) had disseminated yeast infections and received empiric antifungal therapy before confirmation of the diagnosis. Control groups consisted of 22 hematologic patients (76 samples) with either mucosal (n = 10) or urinary (n = 12) Candida colonization and 22 neutropenic patients (34 samples) with no clinical or laboratory signs of invasive yeast infection. Reference values were also obtained from 50 healthy adults (50 samples). The mean urine D-arabinitol/L-arabinitol ratio +/- standard deviation (range) was 16.91 +/- 41.79 (1.41 to 254.75) in patients with disseminated infection, 2.73 +/- 2.48 (1.11 to 19.00) in colonized hematologic patients, 2.12 +/- 0.84 (1.16 to 5.84) in neutropenic controls, and 1.95 +/- 0.34 (0.97 to 3.44) in healthy adults (P < 0.001 between patients with disseminated infection and all control groups). The sensitivity and specificity of the assay for detecting disseminated yeast infection were, respectively, 88 and 91% per patient (upper limit of normal, 4.00). Seventy-one percent of patients already expressed elevated values at the onset of empiric antifungal therapy. The diagnosis of disseminated infection was confirmed on average 21.7 days after the first elevation of the D-arabinitol/L-arabinitol ratio. The method contributes to diagnosis of disseminated yeast infection and helps in monitoring patients at risk, to support the initiation of antifungal therapy at an early stage of the disease.

Adolescent↗
PubMed1996

Bacteraemic pneumococcal disease in a teaching hospital in Finland.

A total of 94 adult patients with bacteraemic pneumococcal disease were retrospectively analyzed for the factors associated with a fatal outcome. Included there were 61 males and 33 females with a mean age of 54.1 =/- 17.7 years. Of all patients, 28 (29.8%) were previously healthy, 66 (70.2%) had at least one chronic underlying disease and 29 (30.9%) were classified as alcohol abusers. The total case-fatality rate was 34%, which is higher than in the other recent Scandinavian studies. The disease was fulminant in 13 patients who died within 24 hours of admission. The mortality was significantly higher among those patients who had underlying diseases than among those who were previously healthy (p = 0.03). In addition, unfavourable prognosis was associated with septic shock on arrival (p = 0.03) respiratory insufficiency requiring mechanical ventilation (p < 0.05) and nosocomial infection (p = 0.03). The patients who succumbed were significantly older that those who survived (p < 0.01). Moreover, the absence of leucocytosis, thrombocytopenia and elevated serum creatinine levels predicted an unfavourable outcome. Contradictory to some previous reports, increased mortality was associated neither with the male sex, alcohol abuse nor the focus of infection. The continuously high mortality and rapid lethality of bacteraemic pneumococcal disease underscore the importance of following the present recommendations on the use of pneumococcal vaccine in high-risk patients.

Adolescent↗
PubMed1995

Use of gas-liquid chromatography for subgrouping coagulase-negative staphylococci during a nosocomial sepsis outbreak.

Gas-liquid chromatographic (GLC) fatty acid profile correlation analysis was applied for the subgrouping of 169 coagulase-negative staphylococci collected during an outbreak of nosocomial sepsis in a hematologic unit. The fatty acid profile similarity index between six ciprofloxacin-resistant Staphylococcus epidermidis septicemia strains was as high as 98.39 +/- 0.68, indicating a high degree of resemblance. This finding corroborated the finding by conventional typing methods that the isolates shared the same strain characteristics and, therefore, could be derived from the same epidemiological origin. Further, the GLC fatty acid profiles were analyzed for coagulase-negative staphylococcal cutaneous isolates recovered from colonization cultures of the patients and personnel in that same unit. The similarity index between 88 ciprofloxacin-resistant Staphylococcus epidermidis skin isolates with similar plasmid profiles was as high as 95.47 +/- 3.78, whereas the correlation coefficient between 45 ciprofloxacin-susceptible Staphylococcus epidermidis skin isolates with different plasmid profiles was only 85.23 +/- 10.82. Cluster analysis grouped the ciprofloxacin-resistant Staphylococcus epidermidis isolates into one distinct cluster, while most of the ciprofloxacin-susceptible Staphylococcus epidermidis isolates were grouped into two separate clusters. When compared with the plasmid profiling, the GLC method congruously grouped 127 (87%) of the 146 Staphylococcus epidermidis isolates, thereby suggesting its potential value in subgrouping coagulase-negative staphylococci during nosocomial outbreaks.

Anti-Infective Agents↗
PubMed1995

Additional tests to differentiate Arcanobacterium haemolyticum and Actinomyces pyogenes.

A commercially available biochemical test panel, commercially available diagnostic tablets and gas-liquid chromatography (GLC) of cellular fatty acids were used to find out whether Arcanobacterium haemolyticum and Actinomyces pyogenes could be further differentiated from each other. Xylitol and alpha-methyl-D-glucoside fermentation, Voges-Proskauer reaction and tributyrate hydrolysis were found to be useful additional tests which differentiated Arc. haemolyticum and A. pyogenes. GLC analysis revealed major differences in the cellular 16:0, 18:2(9,12) and 18:1(9) fatty acid composition of the two species. Especially the Voges-Proskauer test available as diagnostic tablets can be easily performed in clinical microbiology laboratories, in addition to the tests now used to differentiate Arc. haemolyticum from A. pyogenes.

Acetoin↗
PubMed1995

Use of the polymerase chain reaction and DNA sequencing for detection of Bartonella quintana in the aortic valve of a patient with culture-negative infective endocarditis.

We used the polymerase chain reaction (PCR) and broad-range bacterial primers, combined with DNA sequencing, to identify Bartonella quintana as the etiologic agent in a case of culture-negative infective endocarditis; all blood cultures, as well as the bacterial cultures of the resected aortic valve and vegetations, remained negative. PCR was used to amplify bacterial 16S rDNA from a template prepared from the aortic valve vegetation. The amplified 16S rDNA produced a nucleotide sequence that was 99.79% identical to the B. quintana rDNA sequence. The patient had a highly elevated level of serum antibodies to Bartonella antigen (1:8,192).

Antibodies, Bacterial↗
PubMed1995

Muramic acid in peripheral blood leukocytes of healthy human subjects.

Peptidoglycan, a specific marker for all bacterial cell walls, was studied in peripheral blood of healthy human subjects by mass spectrometric analysis of muramic acid. Peripheral blood mononuclear and polymorphonuclear cells from 98 healthy adults were hydrolyzed and analyzed by gas chromatography-mass spectrometry as alditol acetate derivatives using selective ion monitoring. Muramic acid was observed in cell samples from 21 of 98 subjects. Blood cultures were done simultaneously and remained negative. As a control, mononuclear and polymorphonuclear cells separated from umbilical vein blood of 41 healthy newborns were studied; all were muramic acid-negative. Since newborns lack gut flora, intestinal absorption of bacteria or of their degradation products appears to be the most likely explanation for the finding.

Adult↗
PubMed1995

Disk diffusion susceptibility tests: need for laboratory-specific breakpoints.

Significant changes were observed in the measured resistance levels of Escherichia coli and Staphylococcus aureus when the Biodisk disk susceptibility test method used in 1992 was replaced with another commercial method, Oxoid. For example, when non-species-specific breakpoints were used, the frequency of cephalotin-resistant E. coli was 12% of all isolates in 1992 but only 4% in 1993; the corresponding figures for the intermediately resistant isolates were 84% and 8%. The population distribution histograms were however, practically unchanged. Thus, the resistance percentages apparently did not reflect the real development of resistance. Similar findings were also made for several other antimicrobials. Susceptibility test breakpoints should therefore be examined separately for all bacterial species in each laboratory, and the application of adjusted laboratory-specific breakpoints should be considered. For this purpose, the WHONET computer program provides excellent assistance.

Ampicillin↗
PubMed1995

Testing of methicillin resistance by in vitro susceptibility and the presence of the mecA gene in clinical Staphylococcus aureus isolates in Finland.

A total of 140 epidemiologically unrelated Staphylococcus aureus strains collected in Finland between 1983 and 1994 were sent to the reference laboratory with verified or suspected methicillin resistance. These strains and 37 S. aureus strains previously identified as methicillin-susceptible were retested using 5 different susceptibility test methods including agar screening, disc diffusion, growth around methicillin (25 micrograms) test strips and minimal inhibitory concentration (MIC) determinations by an agar dilution method and E-test. The isolates were also analyzed for the presence of the mecA gene by the polymerase chain reaction (PCR). Based on in vitro susceptibility, 69 strains were identified as methicillin-resistant and were positive for the mecA gene in PCR, while 84 strains were methicillin-susceptible and negative for this gene. Susceptibility testing gave conflicting results for 24 (14%) strains. When the tests were repeated in triplicate for each isolate, discrepant results were still achieved with 18 of the 24 strains in at least 2 different tests. Thus, based on in vitro susceptibility, these strains could not be definitely classified as resistant or susceptible to methicillin. Yet 7 of them were positive for the mecA gene as an indication of genetic resistance to methicillin. Corroborating earlier studies, these results illustrate the difficulty of detecting methicillin resistance/susceptibility based only on susceptibility testing and underscore the importance of confirming methicillin resistance in S. aureus in specialized laboratories.

Bacterial Proteins↗
PubMed1994

Intestinal flora in early rheumatoid arthritis.

To study the role of intestinal flora in the pathogenesis of RA, we have applied computerized gas-liquid chromatography (GLC) for bacterial cellular fatty acids (CFAs) present in the stool. The CFA spectra represents the total composition of bacterial CFAs in a faecal sample. Correlation and cluster analysis of CFA spectra gathers samples with quantitatively and qualitatively similar bacterial flora into clusters, which then reveal the relationship of samples to each other. Stool samples were collected at the time of hospital admission from patients with early RA before any specific treatment. The CFA spectra in stool samples of RA patients were significantly different from those of non-RA controls. Patients with erosive RA formed a group most clearly different from the controls. Analyses based on the CFA composition of reference bacteria revealed that anaerobic bacteria are primarily responsible for the differences observed. These results suggest that intestinal bacteria play a role in the development of RA.

Arthritis, Rheumatoid↗
PubMed1994

Synovial fluid muramic acid in acute inflammatory arthritis.

Presence of muramic acid, a bacterial cell wall component, was analysed by gas chromatography-mass spectrometry in synovial fluid (SF) of 40 patients with acute inflammatory arthritis. SF muramic acid was observed in 4/14 patients with acute, culture negative inflammatory arthritis of unclear origin. Each of these four patients had a history of a recent bacterial disease (pansinuitis, purulent leg ulcer, erysipelas, unexplained fever with suspicion of cholecystitis and urinary tract infection). In the bacterial arthritis, SF muramic acid was detected in 6/12 patients (in 2/6 culture negative cases). In the reactive arthritis due to Salmonella or Yersinia, the rate of positivity was 2/14. Nineteen samples of traumatic SF effusion were muramic acid negative. These findings indicate that several cases of undefined acute inflammatory arthritis are of bacterial origin.

Acute Disease↗
PubMed1994

Changes of faecal flora in rheumatoid arthritis during fasting and one-year vegetarian diet.

The beneficial effect of a 1-yr vegetarian diet in RA has recently been demonstrated in a clinical trial. We have analysed stool samples of the 53 RA patients by using direct stool sample gas-liquid chromatography of bacterial cellular fatty acids. Based on repeated clinical assessments disease improvement indices were constructed for the patients. At each time point during the intervention period the patients in the diet group were then assigned either to a group with a high improvement index (HI) or a group with a low improvement index (LI). Significant alteration in the intestinal flora was observed when the patients changed from omnivorous to vegan diet. There was also a significant difference between the periods with vegan and lactovegetarian diets. The faecal flora from patients with HI and LI differed significantly from each other at 1 and 13 months during the diet. This finding of an association between intestinal flora and disease activity may have implications for our understanding of how diet can affect RA.

Arthritis, Rheumatoid↗
PubMed1994

Intestinal microflora in colicky and noncolicky infants: bacterial cultures and gas-liquid chromatography.

To find out whether intestinal microflora in colicky infants is different from that in noncolicky controls, stool samples were collected from colicky infants during colic (n = 55) and at the age of 3 months (n = 46) and compared with samples from age-matched controls (n = 49 and n = 45, respectively). The samples were cultured on several selective and unselective aerobic and anaerobic culture agars, and gas-liquid chromatography of bacterial cellular fatty acids was used to produce fatty-acid profiles of the stool samples. In quantitative bacterial cultures, no differences were found between the colicky and control groups in the amounts of each bacterium. The colicky infants were more frequently colonized with Clostridium difficile during the time of colic than were the age-matched controls. This difference disappeared by age 3 months. The fatty-acid profiles did not differ between the colicky and control groups as a whole at the time of colicky symptoms. At age 3 months, a difference in fatty-acid profiles was found between the colicky infants who had suffered from severe colic and the control infants. The fatty-acid profiles were also influenced by the age of the infant, the mode of delivery, antimicrobial drugs taken by the mother during delivery, and breast-feeding and type of feeding. In conclusion, no difference in intestinal microflora was found between the colicky infants at the time of colic and the controls. However, a difference in bacterial cellular fatty-acid profiles at the age of 3 months was found that correlated with severe infantile colic. This difference may contribute to the cause(s) of colic, or it may be secondary to the colic, which may influence the microbial environment of the intestine.

Chromatography, Gas↗
PubMed1994

Characteristics of 'atypical', cytochrome oxidase-negative Aeromonas salmonicida isolated from ulcerated flounders (Platichthys flesus (L.)).

'Atypical', cytochrome oxidase-negative variants of the fish pathogen Aeromonas salmonicida, isolated from ulcerated flounder (Platichthys flesus), were studied using different methods. Two of the strains possessed a protein that corresponded to the A-layer protein of Aer. salmonicida. The strains reacted with antibodies against the A-layer and monoclonal antibodies against the O-antigen of typical Aer. salmonicida. These tests confirm that the isolates from flounder should be classified as Aer. salmonicida. Analysis of the fatty acids showed that the isolates were rather homogeneous but the values of the guanine plus cytosine content of the DNA of the bacteria varied too much for any conclusion to be drawn on their taxonomic location. The strains examined exhibited several biochemical characters that differed from those of the type strains of Aer. salmonicida subsp. salmonicida and Aer. salmonicida subsp. achromogenes. The results suggest that these 'atypical', cytochrome oxidase-negative variants may form a new subspecies of Aer. salmonicida.

Aeromonas↗